• Journal of Nutrition and Health
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• v.36 no.7
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• pp.749-758
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• 2003

Malnutrition is a common problem in patients undergoing maintenance hemodialysis (HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in these patients. This study was conducted to evaluate the effectiveness of nutrition education at improving nutritional status of 23 Korean HD patients (mean : 48.6 $\pm$ 10.4 years, men : 8, women : 15). Anthropometric indices, nutrient intakes, and biochemical blood indices were measured before and after a 6-month nutrition education intervention. Anthropometric indices such as percent ideal body weight [PIBW (%)], body fat, body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC), and calculated arm muscle area (CAMA) of subjects were within the normal range and not changed by nutrition education. Subjective global assessment (SGA) was significantly increased (p < 0.05) after nutrition education. Intake of total energy, carbohydrate, lipid, Ca, and vitamin B1 was increased significantly (p < 0.05) but intake of phosphorus, potassium, and sodium was decreased (p < 0.05). The serum concentrations of albumin, total protein, and Ca were significantly increased (p < 0.05), but levels of P and K were decreased (p < 0.05) after the intervention. These findings suggest that nutrition education for HD patients can be effective for positively changing nutrient intakes, leading to improvements in blood indices and nutritional status.

• Journal of Nutrition and Health
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• v.33 no.5
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• pp.540-547
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• 2000

The present study was conducted to document North Korea's long standing food shortage situation and to evaluate the devastating effects of its recent food crisis on the already poor health and nutritional state of the people in North Korea. We analyzed the mail survey data on food consumption patterns and anthropometry of 109 North Korean defectors, male, aged 20 years and older, who resettled in the South during the period of 1988-1999. The result of our survey data indicated that during 1988-1993 when North Korea's food supply was not yet emerged as a serious problem, food and nutrient intake of North Korean defectors was estimated to be significantly lower that the recommended intake levels for maintenance. Energy and protein intake of subjects who defected further with the recent food crisis. For subjects who defected after 1994, the total and animal food intakes were reduced to 67% and 25%, respectively, of the amounts consumed by those who defected in the period of 1988-1993, and their energy and protein intake was decreased by 27% and 30% to the level of 1,181kcal and 40g. Regardless of the time of defection, the mean height and body weight of defectors was significantly lower than that of South Korean reference men. The prevalence of infectious diseases and malnutrition signs was higher among defectors who resettled in the South after 1994 compared to those who resettled during 1988-1993.

• Archives of Pharmacal Research
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• v.27 no.7
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• pp.693-712
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• 2004

The rats with protein-calorie malnutrition (PCM, 5％ casein diet for a period of 4-week) were reported to exhibit 60 and 80％ suppression in the hepatic microsomal cytochrome P450 (CYP) 1 A2 and CYP2C11 levels, respectively, and 40-50％ decreases in CYP2E1 and CYP3A 1/2 levels compared to control (23％ casein diet for a period of 4-week) based on Western blot analysis. In addition, Northern blot analysis showed that CYP1 A2, CYP2E1, CYP2C11, and CYP3A1/2 mRNAs decreased in the state of PCM as well. Hence, pharmacokinetic changes of the drugs in rats with PCM [especially the area under the plasma concentration-time curve from time zero to time infinity (AUC) changes of metabolite(s)] reported from literatures were tried to explain in terms of CYP isozyme changes in the rats. Otherwise, the time-averaged nonrenal clearance ($CL_{NR}$) of parent drug was compared. Pharmacokinetic changes of the drugs in other types of malnutritional state, such as kwashiorkor and marasmus, in both human and animal models were also compared. The drugs reviewed are as follows： diuretics, antibiotics, anticancer agents, antiepileptics, antiarrythmics, analgesics, xanthines, antimalarials, and miscellaneous.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.1
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• pp.90-99
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• 2021

Purpose: Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool. Methods: Retrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool. Results: There was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital. Conclusion: The moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.

• Journal of the Korean Society of Food Culture
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• v.38 no.6
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• pp.381-391
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• 2023

This study was conducted to analyze relationships between depression indices, mini nutritional assessment scores, and nutritional quotients among 80 elderly in Yangpyeong-gun and to identify factors that help prevent depression and malnutrition. Nutrition assessment scores were low in the high-risk group (PHQ-9 score ≥10), and nutritional quotient scores were lower in the high-risk group than in the normal group (PHQ-9 score ≤4). Interestingly, the consumption frequencies of fruits, eggs, and nuts were low in the high-risk group, and subjective health awareness, dental condition, and sleep were poorer. The total PHQ-9 score was correlated with malnutrition, body mass index, calf circumference, weight change, independent daily living, reduced meal amount, water intake, and the need for help when eating. Analysis of correlations between items of the PHQ-9 and nutritional status evaluation indices showed that a self-perceived feeling of depression, low energy, difficulty controlling sleep or appetite, negative thoughts (e.g., failure, disappointment), and difficulty concentrating were negatively correlated with total nutritional status scores. These results show that attention is required when food or water intake decreases and that deviation from normal sleep and appetite cycles flags the need to prepare guidelines to prevent depression.

• Nutrition Research and Practice
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• v.17 no.5
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• pp.1007-1018
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine whether the tailored home-delivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea. SUBJECTS/METHODS: Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ² test to validate the test. RESULTS: There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services. CONCLUSIONS: The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.

• Journal of Nutrition and Health
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• v.39 no.7
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• pp.617-623
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• 2006

The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.79-88
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• 2011

Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.

• Radiation Oncology Journal
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• v.30 no.3
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• pp.132-139
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• 2012

Purpose: The purpose of this prospective multi-institutional study was to evaluate the nutritional status of patients undergoing radiotherapy (RT) for treatment of head and neck, lung, or gastrointestinal cancer. Materials and Methods: A total of 1,000 patients were enrolled in this study at seven different hospitals in Seoul, Korea between October 2009 and May 2010. The nutritional status of patients after receiving 3 weeks of RT was evaluated using subjective global assessment (SGA). The nutritional status of each patient was rated as well nourished (A), moderately malnourished (B), or severely malnourished (C). Results: The mean age of patients in this study was $59.4{\pm}11.9$ years, and the male to female ratio was 7:3. According to the SGA results, 60.8%, 34.5%, and 4.7% of patients were classified as A, B, or C, respectively. The following criteria were significantly associated with malnutrition (SGA B or C; p < 0.001): loss of subcutaneous fat or muscle wasting (odds ratio [OR], 11.473); increased metabolic demand/stress (OR, 8.688); ankle, sacral edema, or ascites (OR, 3.234); and weight loss ${\geq}5%$ (OR, 2.299). Conclusion: SGA was applied successfully to assess the nutritional status of most patients. The prevalence of malnutrition in a radiation oncology department was 39.2%. The results of this study serve as a basis for implementation of nutrition intervention to patients being treated at radiation oncology departments.

• Journal of Gastric Cancer
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• v.2 no.4
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• pp.205-212
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• 2002

Purpose: Malnutrition is a common postoperative complication that occurs after gastric resection. Several causes for malnutrition have been proposed, which include malabsorption and poor oral calorie intake. We performed this study to evaluate whether nutritional counseling would increase oral calorie intake and improve nutritional status in patients who had undergone gastrectomy. Materials and Methods: Twenty-two patients were randomly selected as the study group from among patients who had undergone gastrectomy for early gastric cancer and gastric polyp between October 1999 and December 2000. Body weight, hemoglobin, serum albumin, and serum transferrin were checked before and after the gastrectomy. Oral calorie intake was evaluated by using a 3-day oral-intake diary, and one nutritionist performed outpatient-based nutritional counseling. Eighteen patients who had undergone gastrectomy for the same disease during the same period were selected as the control group. Results: During an average interval of 14.8 months, the study patients received nutritional counseling an average of 3.4 times at an average interval of 4.4 months. The study group took a mean of $2055.6\pm418.1$ Cal per day and the control group $1792.1\pm421.9$ Cal (P=0.05). Sixty-eight percent (15 patients) of the study group patients reached the daily-required calorie intake. Postoperative bodyweights were $64.0\pm9.9$ kg for the study group and $64.3\pm10.8$ kg for the control group (P>0.05). No statistically significant differences were observed among the other. Sixty-five percent of the patients (26 patients) had a weight loss of less than $10\%$ of the preoperative body weight, and $35\%$ had more than a $10\%$ weight loss, but there was no statistical difference between the calorie intakes of these patients. Conclusions: Nutritional counselling increased the oral calorie intake, but nutritional status was not improved. These results suggest that nutritional derangement after gastrectomy cannot be corrected by adequate oral intake itself.